Evaluation of a training programme for primary care providers to offer brief behaviour change counselling on risk factors for non-communicable diseases in South Africa

Patient Educ Couns. 2016 Jan;99(1):125-31. doi: 10.1016/j.pec.2015.08.008. Epub 2015 Aug 14.

Abstract

Objective: To evaluate the effect on clinical practice of training primary care providers (PCPs) in an approach to brief behaviour change counselling (BBCC), integrating the 5As (ask, alert, assess, assist, arrange) with a guiding style derived from motivational interviewing in the South African context. BBCC was focused on the four risky behaviours (unhealthy eating, tobacco smoking, physical inactivity, harmful alcohol use) for non-communicable diseases.

Methods: It was a before-and-after design, recording BBCC skills at baseline, directly after training and 6-weeks later. We evaluated each recording for adherence to the guiding style and delivery of the 5As using the Motivational Interviewing Treatment Integrity 3.1.1. tool, and a tool based on the 5As training design.

Results: 123 recordings were collected from 41 PCPs. Results showed a significant improvement in adoption of the guiding style (e.g. global score at baseline 2.0 (2.0-2.6) and in clinical practice 3.0 (2.7-3.3) p<0.001) and completion of the 5A steps (e.g. assist score at baseline 1.26 (1.12-1.4) and in clinical practice 1.75 (1.61-1.89) p<0.001).

Conclusion: Training PCPs in this approach to BBCC is effective at changing their clinical practice in the short term.

Practice implications: The training programme should be integrated into the curricula of PCPs, and used in continuing professional development.

Keywords: Brief behaviour change counselling; Clinical nurse practitioners; Motivational interviewing; Primary care physicians; Training programmes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Clinical Competence*
  • Directive Counseling / methods*
  • Education, Medical, Continuing / methods*
  • Health Behavior
  • Health Promotion / methods*
  • Humans
  • Motivational Interviewing / methods
  • Primary Health Care / methods*
  • Program Evaluation*
  • South Africa